Cases of vascular tumour of the urethra, with remarks / [Henry Burford Norman].

  • Norman, Henry Burford, 1819-1900.
Date:
1849
Catalogue details

Licence: Public Domain Mark

Credit: Cases of vascular tumour of the urethra, with remarks / [Henry Burford Norman]. Source: Wellcome Collection.

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    urethra, and generally produce great pain, especially in making water, on which account the disease has been sometimes mistaken for a calculous affection. The agony is at times so great as to excite convulsions; and it is not uncommon for the patient to have an increase of her sufferings about the menstrual period. The tumour is vascular, florid, moveable, and exceedingly tender. When ex¬ crescences grow about the orifice of the urethra, they are readily discovered; but, when they grow high up, it is much more difficult to ascertain their existence.” Dr Baillie1 says they u cannot be known but by the sensation of a catheter passing over a soft body.” Burns refers to many interesting cases, hereinafter to be cited. The late Dr David Davis makes mention of these tumours, and gives a most interesting and complicated case in illustration (see Case 9). Sir B. Brodie2 limits their size to that “ of a pea, or horse- bean.” He has met with many instances of them. Dr Ashwell3 4 thus treats the subject:—“ This is by no means an unfrequent affection of the mucous membrane of the urethra. It usually attacks the young, whether married or single; is very rare¬ ly seen after the cessation of the menses; consists of a small granu¬ lar tumour, generally pediculated and moveable, attached to one part of the margin of the meatus, or just within the urethra, whose two prominent characteristics are great vascularity and exquisite sensi¬ bility. Sometimes these growths are not moveable, but appear like several raised coalesced granulations, or occasionally two or more isolated independent ones may be seen near together. Every now and then they extend partially along the urethra, and may even be located at the neck of the bladder. They are covered by a delicate pale4 mucous membrane, which is broken on being touched during examination, and blood exudes from the soft, feeble, and injected capillaries. If they interrupt or come in contact with the stream of urine, the act of passing water causes intense pain, and this is usually the first and most constant symptom of the com¬ plaint. After a time the urethra and bladder become irritable, and the frequent desire to micturate is suppressed by the dread of the pain which it excites. Sexual intercourse is intensely painful, and is therefore obliged to be suspended. Walking exercise is attended with suffering, and in fact any movement of the vulva, by slightly displacing or pressing upon the growth, produces instant pain.” Leucorrhoea, and various sympathetic pains of the pelvis, loins, &c., are mentioned as accompanying the tumour. Mr Safford Lee5 has met with these tumours “in the young and 1 Morbid Anatomy. P. 321. 2 Lectures on Diseases of the Urinary Organs. Third edition, p. 02. 3 Ashwell on the Diseases of Women. Second edition, p. 710. 4 Dr Ashwell, in this description of the covering of the tumour, differs from all others, who speak of it as “ florid” in appearance. 5 Tumours of the Uterus and its Appendages.
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